OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule (1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules). This Rule is not met as evidenced by: Based on observation and interview, it was determined the facility failed to maintain the kitchen in good repair and in a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. Findings include, but are not limited to: Observation of the facility kitchen on 04/24/26, from 11:00 am through 2:00 pm, found the following: a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, and/or black matter was visible on or underneath the following: * Removable hood vents above stove; * Interior of ovens; * Removable drip pans under stove top; * Lids of plastic storage containers; * Piping under prep sink; * Metal molding around floor/cove base; and * Window and windowsill area in outside dry storage area. b. Multiple food items were found in the reach-in refrigerators without proper labels and/or open and/or use-by dates. c. Multiple food items were found open past seven days and should have been discarded. d. Staff 3 (Cook) and Staff 2 (Head Chef/Person In Charge) were observed to contaminate their gloves and then handle ready-to-eat (RTE) foods. e. Staff 3 was observed touching RTE foods with his bare hands, using the back of his hand to feel the temperature of a food product, and to use his hand as a utensil to serve vegetables on a plate. f. Staff 3 was observed to have a kitchen towel tucked into the waistline of his clothing. He was observed to wipe his hands on the towel when going about tasks, potentially contaminating the towel and his hands. g. Staff 3 was unable to articulate proper cold food storage temperatures or cleaning schedules, nor demonstrate proper glove use. During a conversation on 04/24/26 with both Staff 1 (Administrator) and Staff 2, they acknowledged Staff 3 was the person in charge (PIC) two days a week. Staff 2 and 3 indicated that Staff 3 was new and acknowledged he did not have adequate training or knowledge to be considered a PIC of the food establishment. Staff 1 stated that Staff 3 would receive more training prior to being given PIC duties and responsibilities. h. RTE shelf stable health shake drinks were observed stored directly under the drain of the prep sink. The piping was observed coated with dust/dirt and debris. i. The facility was using recycled plastic containers from different manufactured products (such as sour cream, cottage cheese, etc.) to store opened bulk food products (such as tea bags, applesauce, pudding, sugar, etc.), after the containers had been emptied and washed. At 12:00 pm, the surveyor reviewed the above areas with Staff 2 who acknowledged areas in need of attention. Staff 1 (Administrator) was informed of the above areas at approximately 12:30 pm, and she acknowledged the identified areas.

A. The kitchen will be deep cleaned and the cleaning list will be updated to inclued the issues listed in section (a). Administration will work with PIC to ensure that the areas question are cleaned and maintained properly and reviewed quarterly. B. Staff will be re-trained in an all staff training on 5-20- 2026 on the importance of labeling and dating food before putting food away. Admin will work with PIC to monitor quarterly. C. Staff will be re-trained in an all staff meeting on 5-20- 2026 on checking the dates of leftover food in the refrigerator and discarding after the ch day. All cooks will check the leftovers daily for food that needs to be discarded. Admin and PIC will mintor quarterly. Signs will be placed as reminders. D. All kitchen staff will be re-trained on proper hand hygiene and use of gloves in the Kitchen. Policy will be in place regarding proper use of gloves and proper hand hygiene. Administration and PIC will work together to monitor. E. All kitchen staff will be re-trained on proper use of utensils and proper hand hygiene practices. A policy will be in place addressing both. Administration and PIC will work together to monitor. F. Kitchen staff will be re-trained on proper hand hygiene and not re-using a hand towel. Signs will be posted and quarterly training will be administered to all kitchen staff. G. Staff #13 is no longer working for Still Waters. Moving forward all new kitchen staff will work more closely with PIC and demonstrate competency and knowledge of the food code before bieng left on their own. H. The shelf stable drinks have been relocated. A policy wil be in place regarding safe storefe of RTE items. Admin and PIC will monitor quarterly. I. New containers have been purchased to replace the recycled food grade containers that were previousley used.

OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule (1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules). This Rule is not met as evidenced by: Based on observation and interview, it was determined the facility failed to maintain the kitchen in a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. This is a repeat citation. Findings include, but are not limited to: Observation of the facility kitchen on 07/23/26, from 9:55 am through 10:45 am, found the following: a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, and/or black matter was visible on or underneath the following: * Interior of ovens; and * Removable drip pans under stove top. b. Food was stored in a manner that posed the potential for cross contamination. A carton of unpasteurized whole shell eggs was stored directly above multiple containers of ready-to-drink juices/beverages. A cracked and open raw egg was observed in the carton. A large chub of raw ground beef was stored above/overlapping a container/package of ready-to-eat deli meat and package of hot dogs. Both examples posed a high cross contamination risk of ready-to-eat or drink items. Staff 1 (Administrator) was shown these examples and acknowledged the cross contamination risk and that those items were improperly stored. c. Staff 2 was observed to handle dirty dishes and did not properly wash hands before moving to clean tasks. When Staff 2 washed his hands, he only washed for 5 seconds, not the necessary 20 seconds needed to ensure effective hand washing. d. Staff 2 was observed touching ready-to-eat muffins with his bare hands. e. Staff 2 was observed to engage in food preparation without the use of effective hair restraints. At 10:45 am, the surveyor reviewed the above areas with Staff 1 (Administrator), and she acknowledged the identified areas.

a. Oven and drip pan cleaning will be placed on the weekly kitchen cleaning schedule. PIC will ensure that this task is completed weekly and as needed to maintain cleanliness. b. Raw eggs have been moved to the bottom shelf of the cooler. Separate containers are available for the raw and ready to eat products. A diagram will be placed on the cooler so that all staff knows where to put food when it comes in. Admin will work with PIC to ensure the diagram is accurate and adhered to by all staff. This will be checked daily by PIC and spotted checked at random by admin. c. All staff has been assigned a re-training onproper hand hygiene that will be completed by 9-6-26. Keeping Food Safe and Basic Hand hygiene on Oregon Care Partners. Admin will ensure all staff complete the trainings by 9-6-2026 d. All staff will be re-trained by 9-6-2026 in an all staff meeting on not touching ready to eat food with bare hands. This will also be covered in the Keeping Food Safe , Oregon Care Partners training. Admin will observe and do random spot checks to ensure that staff is following safe food handling practices. e. Staff have been re-trained in the use of hair restraints in the kitchen. The training will be both in person and covered in the Oregon Care Partners training. Admin will observe randomly to ensure that all staff working in the kitchen and serving the food have their hair restrained in accordance with food safety rules.

OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule (1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules). This Rule is not met as evidenced by:

OAR 411-054-0105 (2-4) Inspections and Investigation: Insp Interval (Amended 12/15/21)(2) The facility shall not interfere with a good faith disclosure of information by an employee or volunteer concerning abuse or other action affecting a resident's safety or welfare, as described in OAR 411-054-0028(4).(3) Staff of the Department shall visit and inspect every facility at least but not limited to once every two years for a full in-person survey to determine whether the facility is maintained and operated in accordance with these rules.(a) For each year during which a facility does not have a full survey, the Department shall conduct an in-person inspection of the kitchen and other areas where food is prepared for residents.(b) Subsection (a) will not go into effect until July 1, 2022.(c) Facilities not in compliance with these rules must submit, within ten days of receipt of the inspection report, a plan of correction that satisfies the Department.(d) The Department may impose sanctions for failure to comply with these rules.(4) Department staff may consult with and advise the facility administrator concerning methods of care, records, housing, equipment, and other areas of operation. This Rule is not met as evidenced by: Based on interview, observation, and record review, it was determined the facility failed to ensure their kitchen survey plan of correction was implemented and satisfied the Department. Findings include, but are not limited to: Refer to C 240.

Refer to C 240.

OAR 411-054-0105 (2-4) Inspections and Investigation: Insp Interval (Amended 12/15/21)(2) The facility shall not interfere with a good faith disclosure of information by an employee or volunteer concerning abuse or other action affecting a resident's safety or welfare, as described in OAR 411-054-0028(4).(3) Staff of the Department shall visit and inspect every facility at least but not limited to once every two years for a full in-person survey to determine whether the facility is maintained and operated in accordance with these rules.(a) For each year during which a facility does not have a full survey, the Department shall conduct an in-person inspection of the kitchen and other areas where food is prepared for residents.(b) Subsection (a) will not go into effect until July 1, 2022.(c) Facilities not in compliance with these rules must submit, within ten days of receipt of the inspection report, a plan of correction that satisfies the Department.(d) The Department may impose sanctions for failure to comply with these rules.(4) Department staff may consult with and advise the facility administrator concerning methods of care, records, housing, equipment, and other areas of operation. This Rule is not met as evidenced by: